Arthroscopic treatment of osteochondral knee defects with resorbable biphasic synthetic scaffold: clinical and radiological results and long-term survival analysis

Int Orthop. 2019 Sep;43(9):2183-2189. doi: 10.1007/s00264-018-4270-7. Epub 2018 Dec 11.

Abstract

Purpose: The aim of our study is to evaluate the long-term results in patients treated with a fully arthroscopic TruFit system for osteochondral lesions of the femoral condyle, analyzing the clinical and radiological outcomes, survival rate, complications, and correlations.

Methods: The study included all patients treated with the TruFit system with a full-thickness focal lesion of the knee cartilage (grade IV according to the ICRS classification), entirely arthroscopically with a minimum follow-up of five years. All patients were evaluated clinically prior to surgery (T0) and at two consecutive follow-ups (T1 36.4 ± 17.03 months and T2 101.63 ± 19.02 months), using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Hospital for Special Surgery Score (HSS). At the final follow-up, the magnetic resonance imaging (MRI) was evaluated by two orthopaedists using the magnetic resonance observation of cartilage repair tissue (MOCART) score.

Results: The sample was formed of 21 patients, of which 14 were males (67%) and 7 females (33%), with a mean age of 51.29 ± 10.70. Of the 21 patients, two underwent prosthetic knee replacement at 24 and 65 months, respectively. At T0, the HSS and the KOOS score were, respectively, 60.71 ± 11.62 and 57.71 ± 6.11. For both clinical values, a significant improvement was noted between T0 and T1 (p < 0.05) and between T0 and T2 (p < 0.05). At the final follow-up, the MOCART value was found to be 45.78 ± 5.27.

Conclusions: The study results highlighted the safety and potential of the arthroscopic TruFit system procedure, which offered a good clinical outcome with stable results at long-term follow-up although we found no correlations between the MRI and clinical results.

Keywords: Arthroscopy; Cartilage; MOCART; Osteochondral defects; Scaffold; The Kaplan-Meier survival analysis.

MeSH terms

  • Absorbable Implants
  • Adult
  • Arthroscopy
  • Biocompatible Materials
  • Bone Substitutes / therapeutic use*
  • Cartilage Diseases / surgery*
  • Cartilage, Articular / diagnostic imaging
  • Cartilage, Articular / injuries
  • Cartilage, Articular / surgery*
  • Female
  • Femur / diagnostic imaging
  • Femur / injuries
  • Femur / surgery*
  • Follow-Up Studies
  • Humans
  • Knee Joint / diagnostic imaging
  • Knee Joint / surgery*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Prosthesis Failure
  • Tissue Scaffolds*
  • Young Adult

Substances

  • Biocompatible Materials
  • Bone Substitutes